Workflow automation on policy updates

ABSTRACT

Embodiments of the present disclosure are directed to methods and systems for the timely processing of records exchanged between service provider systems and responsible entity systems by a records management and processing system. More specifically, the records management and processing system can maintain a set of rules defining conditions for processing records and associated actions to affect that processing upon satisfaction of or failure to satisfy the conditions of that rule. Updates to some or all of these records can be received from a data update service. The records management and processing system can apply the rules to the records and assign tags to the records based on the received update information and the conditions defined in the applied rules. The records management and processing system can then process the updated records according to workflows for processing the updated records based on the assigned tags and applied rules.

FIELD OF THE DISCLOSURE

Embodiments of the present disclosure relate generally to methods andsystems for managing transaction records in a database and moreparticularly to implementing updates directed to the processing ofdatabase records.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram illustrating elements of an exemplarycomputing environment in which embodiments of the present disclosure maybe implemented.

FIG. 2 is a block diagram illustrating elements of an exemplarycomputing device in which embodiments of the present disclosure may beimplemented.

FIG. 3 is a block diagram illustrating an exemplary environment in whicha records management and processing system and data collection servicecan be implemented according to one embodiment of the presentdisclosure.

FIG. 4 is a block diagram illustrating elements of an exemplary recordsmanagement and processing system according to one embodiment of thepresent disclosure.

FIG. 5 is a flowchart illustrating an exemplary process for implementingupdates directed to the processing of database records according to oneembodiment of the present disclosure.

In the appended figures, similar components and/or features may have thesame reference label. Further, various components of the same type maybe distinguished by following the reference label by a letter thatdistinguishes among the similar components. If only the first referencelabel is used in the specification, the description is applicable to anyone of the similar components having the same first reference labelirrespective of the second reference label.

DETAILED DESCRIPTION

In the following description, for the purposes of explanation, numerousspecific details are set forth in order to provide a thoroughunderstanding of various embodiments disclosed herein. It will beapparent, however, to one skilled in the art that various embodiments ofthe present disclosure may be practiced without some of these specificdetails. The ensuing description provides exemplary embodiments only,and is not intended to limit the scope or applicability of thedisclosure. Furthermore, to avoid unnecessarily obscuring the presentdisclosure, the preceding description omits a number of known structuresand devices. This omission is not to be construed as a limitation of thescopes of the claims. Rather, the ensuing description of the exemplaryembodiments will provide those skilled in the art with an enablingdescription for implementing an exemplary embodiment. It should howeverbe appreciated that the present disclosure may be practiced in a varietyof ways beyond the specific detail set forth herein.

While the exemplary aspects, embodiments, and/or configurationsillustrated herein show the various components of the system collocated,certain components of the system can be located remotely, at distantportions of a distributed network, such as a LAN and/or the Internet, orwithin a dedicated system. Thus, it should be appreciated, that thecomponents of the system can be combined in to one or more devices orcollocated on a particular node of a distributed network, such as ananalog and/or digital telecommunications network, a packet-switchnetwork, or a circuit-switched network. It will be appreciated from thefollowing description, and for reasons of computational efficiency, thatthe components of the system can be arranged at any location within adistributed network of components without affecting the operation of thesystem.

Furthermore, it should be appreciated that the various links connectingthe elements can be wired or wireless links, or any combination thereof,or any other known or later developed element(s) that is capable ofsupplying and/or communicating data to and from the connected elements.These wired or wireless links can also be secure links and may becapable of communicating encrypted information. Transmission media usedas links, for example, can be any suitable carrier for electricalsignals, including coaxial cables, copper wire and fiber optics, and maytake the form of acoustic or light waves, such as those generated duringradio-wave and infra-red data communications.

As used herein, the phrases “at least one,” “one or more,” “or,” and“and/or” are open-ended expressions that are both conjunctive anddisjunctive in operation. For example, each of the expressions “at leastone of A, B and C,” “at least one of A, B, or C,” “one or more of A, B,and C,” “one or more of A, B, or C,” “A, B, and/or C,” and “A, B, or C”means A alone, B alone, C alone, A and B together, A and C together, Band C together, or A, B and C together.

The term “a” or “an” entity refers to one or more of that entity. Assuch, the terms “a” (or “an”), “one or more” and “at least one” can beused interchangeably herein. It is also to be noted that the terms“comprising,” “including,” and “having” can be used interchangeably.

The term “automatic” and variations thereof, as used herein, refers toany process or operation done without material human input when theprocess or operation is performed. However, a process or operation canbe automatic, even though performance of the process or operation usesmaterial or immaterial human input, if the input is received beforeperformance of the process or operation. Human input is deemed to bematerial if such input influences how the process or operation will beperformed. Human input that consents to the performance of the processor operation is not deemed to be “material.”

The term “computer-readable medium” as used herein refers to anytangible storage and/or transmission medium that participate inproviding instructions to a processor for execution. Such a medium maytake many forms, including but not limited to, non-volatile media,volatile media, and transmission media. Non-volatile media includes, forexample, NVRAM, or magnetic or optical disks. Volatile media includesdynamic memory, such as main memory. Common forms of computer-readablemedia include, for example, a floppy disk, a flexible disk, hard disk,magnetic tape, or any other magnetic medium, magneto-optical medium, aCD-ROM, any other optical medium, punch cards, paper tape, any otherphysical medium with patterns of holes, a RAM, a PROM, and EPROM, aFLASH-EPROM, a solid state medium like a memory card, any other memorychip or cartridge, a carrier wave as described hereinafter, or any othermedium from which a computer can read. A digital file attachment toe-mail or other self-contained information archive or set of archives isconsidered a distribution medium equivalent to a tangible storagemedium. When the computer-readable media is configured as a database, itis to be understood that the database may be any type of database, suchas relational, hierarchical, object-oriented, and/or the like.Accordingly, the disclosure is considered to include a tangible storagemedium or distribution medium and prior art-recognized equivalents andsuccessor media, in which the software implementations of the presentdisclosure are stored.

A “computer readable signal” medium may include a propagated data signalwith computer readable program code embodied therein, for example, inbaseband or as part of a carrier wave. Such a propagated signal may takeany of a variety of forms, including, but not limited to,electro-magnetic, optical, or any suitable combination thereof. Acomputer readable signal medium may be any computer readable medium thatis not a computer readable storage medium and that can communicate,propagate, or transport a program for use by or in connection with aninstruction execution system, apparatus, or device. Program codeembodied on a computer readable medium may be transmitted using anyappropriate medium, including but not limited to wireless, wireline,optical fiber cable, RF, etc., or any suitable combination of theforegoing.

The terms “determine,” “calculate,” and “compute,” and variationsthereof, as used herein, are used interchangeably and include any typeof methodology, process, mathematical operation or technique.

It shall be understood that the term “means” as used herein shall begiven its broadest possible interpretation in accordance with 35 U.S.C.,Section 112, Paragraph 6. Accordingly, a claim incorporating the term“means” shall cover all structures, materials, or acts set forth herein,and all of the equivalents thereof. Further, the structures, materialsor acts and the equivalents thereof shall include all those described inthe summary of the disclosure, brief description of the drawings,detailed description, abstract, and claims themselves.

Aspects of the present disclosure may take the form of an entirelyhardware embodiment, an entirely software embodiment (includingfirmware, resident software, micro-code, etc.) or an embodimentcombining software and hardware aspects that may all generally bereferred to herein as a “circuit,” “module” or “system.” Any combinationof one or more computer readable medium(s) may be utilized. The computerreadable medium may be a computer readable signal medium or a computerreadable storage medium.

In yet another embodiment, the systems and methods of this disclosurecan be implemented in conjunction with a special purpose computer, aprogrammed microprocessor or microcontroller and peripheral integratedcircuit element(s), an ASIC or other integrated circuit, a digitalsignal processor, a hard-wired electronic or logic circuit such asdiscrete element circuit, a programmable logic device or gate array suchas PLD, PLA, FPGA, PAL, special purpose computer, any comparable means,or the like. In general, any device(s) or means capable of implementingthe methodology illustrated herein can be used to implement the variousaspects of this disclosure. Exemplary hardware that can be used for thedisclosed embodiments, configurations, and aspects includes computers,handheld devices, telephones (e.g., cellular, Internet enabled, digital,analog, hybrids, and others), and other hardware known in the art. Someof these devices include processors (e.g., a single or multiplemicroprocessors), memory, nonvolatile storage, input devices, and outputdevices. Furthermore, alternative software implementations including,but not limited to, distributed processing or component/objectdistributed processing, parallel processing, or virtual machineprocessing can also be constructed to implement the methods describedherein.

Examples of the processors as described herein may include, but are notlimited to, at least one of Qualcomm® Snapdragon® 800 and 801, Qualcomm®Snapdragon® 610 and 615 with 4G LTE Integration and 64-bit computing,Apple® A7 processor with 64-bit architecture, Apple® M7 motioncoprocessors, Samsung® Exynos® series, the Intel® Core™ family ofprocessors, the Intel® Xeon® family of processors, the Intel® Atom™family of processors, the Intel Itanium® family of processors, Intel®Core® i5-4670K and i7-4770K 22 nm Haswell, Intel® Core® i5-3570K 22 nmIvy Bridge, the AMD® FX™ family of processors, AMD® FX-4300, FX-6300,and FX-8350 32 nm Vishera, AMD® Kaveri processors, Texas Instruments®Jacinto C6000™ automotive infotainment processors, Texas Instruments®OMAP™ automotive-grade mobile processors, ARM® Cortex™-M processors,ARM® Cortex-A and ARIVI926EJS™ processors, other industry-equivalentprocessors, and may perform computational functions using any known orfuture-developed standard, instruction set, libraries, and/orarchitecture.

In yet another embodiment, the disclosed methods may be readilyimplemented in conjunction with software using object or object-orientedsoftware development environments that provide portable source code thatcan be used on a variety of computer or workstation platforms.Alternatively, the disclosed system may be implemented partially orfully in hardware using standard logic circuits or VLSI design. Whethersoftware or hardware is used to implement the systems in accordance withthis disclosure is dependent on the speed and/or efficiency requirementsof the system, the particular function, and the particular software orhardware systems or microprocessor or microcomputer systems beingutilized.

In yet another embodiment, the disclosed methods may be partiallyimplemented in software that can be stored on a storage medium, executedon programmed general-purpose computer with the cooperation of acontroller and memory, a special purpose computer, a microprocessor, orthe like. In these instances, the systems and methods of this disclosurecan be implemented as program embedded on personal computer such as anapplet, JAVA® or CGI script, as a resource residing on a server orcomputer workstation, as a routine embedded in a dedicated measurementsystem, system component, or the like. The system can also beimplemented by physically incorporating the system and/or method into asoftware and/or hardware system.

Although the present disclosure describes components and functionsimplemented in the aspects, embodiments, and/or configurations withreference to particular standards and protocols, the aspects,embodiments, and/or configurations are not limited to such standards andprotocols. Other similar standards and protocols not mentioned hereinare in existence and are considered to be included in the presentdisclosure. Moreover, the standards and protocols mentioned herein andother similar standards and protocols not mentioned herein areperiodically superseded by faster or more effective equivalents havingessentially the same functions. Such replacement standards and protocolshaving the same functions are considered equivalents included in thepresent disclosure.

Various additional details of embodiments of the present disclosure willbe described below with reference to the figures. While the flowchartswill be discussed and illustrated in relation to a particular sequenceof events, it should be appreciated that changes, additions, andomissions to this sequence can occur without materially affecting theoperation of the disclosed embodiments, configuration, and aspects.

FIG. 1 is a block diagram illustrating elements of an exemplarycomputing environment in which embodiments of the present disclosure maybe implemented. More specifically, this example illustrates a computingenvironment 100 that may function as the servers, user computers, orother systems provided and described herein. The environment 100includes one or more user computers, or computing devices, such as acomputing device 104, a communication device 108, and/or more 112. Thecomputing devices 104, 108, 112 may include general purpose personalcomputers (including, merely by way of example, personal computers,and/or laptop computers running various versions of Microsoft Corp.'sWindows® and/or Apple Corp.'s Macintosh® operating systems) and/orworkstation computers running any of a variety of commercially-availableUNIX® or UNIX-like operating systems. These computing devices 104, 108,112 may also have any of a variety of applications, including forexample, database client and/or server applications, and web browserapplications. Alternatively, the computing devices 104, 108, 112 may beany other electronic device, such as a thin-client computer,Internet-enabled mobile telephone, and/or personal digital assistant,capable of communicating via a network 110 and/or displaying andnavigating web pages or other types of electronic documents. Althoughthe exemplary computer environment 100 is shown with two computingdevices, any number of user computers or computing devices may besupported.

Environment 100 further includes a network 110. The network 110 may canbe any type of network familiar to those skilled in the art that cansupport data communications using any of a variety ofcommercially-available protocols, including without limitation SIP,TCP/IP, SNA, IPX, AppleTalk, and the like. Merely by way of example, thenetwork 110 maybe a local area network (“LAN”), such as an Ethernetnetwork, a Token-Ring network and/or the like; a wide-area network; avirtual network, including without limitation a virtual private network(“VPN”); the Internet; an intranet; an extranet; a public switchedtelephone network (“PSTN”); an infra-red network; a wireless network(e.g., a network operating under any of the IEEE 802.9 suite ofprotocols, the Bluetooth® protocol known in the art, and/or any otherwireless protocol); and/or any combination of these and/or othernetworks.

The system may also include one or more servers 114, 116. In thisexample, server 114 is shown as a web server and server 116 is shown asan application server. The web server 114, which may be used to processrequests for web pages or other electronic documents from computingdevices 104, 108, 112. The web server 114 can be running an operatingsystem including any of those discussed above, as well as anycommercially-available server operating systems. The web server 114 canalso run a variety of server applications, including SIP (SessionInitiation Protocol) servers, HTTP(s) servers, FTP servers, CGI servers,database servers, Java servers, and the like. In some instances, the webserver 114 may publish operations available operations as one or moreweb services.

The environment 100 may also include one or more file and or/applicationservers 116, which can, in addition to an operating system, include oneor more applications accessible by a client running on one or more ofthe computing devices 104, 108, 112. The server(s) 116 and/or 114 may beone or more general purpose computers capable of executing programs orscripts in response to the computing devices 104, 108, 112. As oneexample, the server 116, 114 may execute one or more web applications.The web application may be implemented as one or more scripts orprograms written in any programming language, such as Java™, C, C #®, orC++, and/or any scripting language, such as Perl, Python, or TCL, aswell as combinations of any programming/scripting languages. Theapplication server(s) 116 may also include database servers, includingwithout limitation those commercially available from Oracle®,Microsoft®, Sybase®, IBM® and the like, which can process requests fromdatabase clients running on a computing device 104, 108, 112.

The web pages created by the server 114 and/or 116 may be forwarded to acomputing device 104, 108, 112 via a web (file) server 114, 116.Similarly, the web server 114 may be able to receive web page requests,web services invocations, and/or input data from a computing device 104,108, 112 (e.g., a user computer, etc.) and can forward the web pagerequests and/or input data to the web (application) server 116. Infurther embodiments, the server 116 may function as a file server.Although for ease of description, FIG. 1 illustrates a separate webserver 114 and file/application server 116, those skilled in the artwill recognize that the functions described with respect to servers 114,116 may be performed by a single server and/or a plurality ofspecialized servers, depending on implementation-specific needs andparameters. The computer systems 104, 108, 112, web (file) server 114and/or web (application) server 116 may function as the system, devices,or components described herein.

The environment 100 may also include a database 118. The database 118may reside in a variety of locations. By way of example, database 118may reside on a storage medium local to (and/or resident in) one or moreof the computers 104, 108, 112, 114, 116. Alternatively, it may beremote from any or all of the computers 104, 108, 112, 114, 116, and incommunication (e.g., via the network 110) with one or more of these. Thedatabase 118 may reside in a storage-area network (“SAN”) familiar tothose skilled in the art. Similarly, any necessary files for performingthe functions attributed to the computers 104, 108, 112, 114, 116 may bestored locally on the respective computer and/or remotely, asappropriate. The database 118 may be a relational database, such asOracle 20i®, that is adapted to store, update, and retrieve data inresponse to SQL-formatted commands.

FIG. 2 is a block diagram illustrating elements of an exemplarycomputing device in which embodiments of the present disclosure may beimplemented. More specifically, this example illustrates one embodimentof a computer system 200 upon which the servers, user computers,computing devices, or other systems or components described above may bedeployed or executed. The computer system 200 is shown comprisinghardware elements that may be electrically coupled via a bus 204. Thehardware elements may include one or more central processing units(CPUs) 208; one or more input devices 212 (e.g., a mouse, a keyboard,etc.); and one or more output devices 216 (e.g., a display device, aprinter, etc.). The computer system 200 may also include one or morestorage devices 220. By way of example, storage device(s) 220 may bedisk drives, optical storage devices, solid-state storage devices suchas a random-access memory (“RAM”) and/or a read-only memory (“ROM”),which can be programmable, flash-updateable and/or the like.

The computer system 200 may additionally include a computer-readablestorage media reader 224; a communications system 228 (e.g., a modem, anetwork card (wireless or wired), an infra-red communication device,etc.); and working memory 236, which may include RAM and ROM devices asdescribed above. The computer system 200 may also include a processingacceleration unit 232, which can include a DSP, a special-purposeprocessor, and/or the like.

The computer-readable storage media reader 224 can further be connectedto a computer-readable storage medium, together (and, optionally, incombination with storage device(s) 220) comprehensively representingremote, local, fixed, and/or removable storage devices plus storagemedia for temporarily and/or more permanently containingcomputer-readable information. The communications system 228 may permitdata to be exchanged with a network and/or any other computer describedabove with respect to the computer environments described herein.Moreover, as disclosed herein, the term “storage medium” may representone or more devices for storing data, including read only memory (ROM),random access memory (RAM), magnetic RAM, core memory, magnetic diskstorage mediums, optical storage mediums, flash memory devices and/orother machine-readable mediums for storing information.

The computer system 200 may also comprise software elements, shown asbeing currently located within a working memory 236, including anoperating system 240 and/or other code 244. It should be appreciatedthat alternate embodiments of a computer system 200 may have numerousvariations from that described above. For example, customized hardwaremight also be used and/or particular elements might be implemented inhardware, software (including portable software, such as applets), orboth. Further, connection to other computing devices such as networkinput/output devices may be employed.

Examples of the processors 208 as described herein may include, but arenot limited to, at least one of Qualcomm® Snapdragon® 800 and 801,Qualcomm® Snapdragon® 620 and 615 with 4G LTE Integration and 64-bitcomputing, Apple® A7 processor with 64-bit architecture, Apple® M7motion coprocessors, Samsung® Exynos® series, the Intel® Core™ family ofprocessors, the Intel® Xeon® family of processors, the Intel® Atom™family of processors, the Intel Itanium® family of processors, Intel®Core® i5-4670K and i7-4770K 22 nm Haswell, Intel® Core® i5-3570K 22 nmIvy Bridge, the AMD® FX™ family of processors, AMD® FX-4300, FX-6300,and FX-8350 32 nm Vishera, AMD® Kaveri processors, Texas Instruments®Jacinto C6000™ automotive infotainment processors, Texas Instruments®OMAP™ automotive-grade mobile processors, ARM® Cortex™-M processors,ARM® Cortex-A and ARIVI926EJS™ processors, other industry-equivalentprocessors, and may perform computational functions using any known orfuture-developed standard, instruction set, libraries, and/orarchitecture.

FIG. 3 is a block diagram illustrating an exemplary environment in whicha records management and processing system and data collection servicecan be implemented according to one embodiment of the presentdisclosure. As illustrated in this example, the environment 300 caninclude a number of different systems. Specifically, the environment 300can include a records management and processing system 305 which cancomprise a server or other computing device as described above. Therecords management and processing system 305 can be communicativelycoupled with a communication network 310 such as the Internet or anyother one or more wired or wireless, local or wide area networks. Theenvironment 300 can also include a number of service provider systems315A-315C each of which can comprise a server or other computing deviceas described above and which can also be communicatively coupled withthe communication network 310. Furthermore, the environment 300 caninclude a number of responsible entity systems 320A-320C each of whichcan comprise a server or other computing device as described above andwhich can also be communicatively coupled with the communication network310. It should be noted that while three service provider systems315A-315C and three responsible entity systems 320A-320C are shown herefor illustrative purposes, any number of such systems 315A-315C and320A-320C can be present in various different implementations withoutdeparting from the scope of the present disclosure.

According to one implementation, the service provider systems 315A-315Ccan represent those servers or other computer systems typicallyassociated with an entity providing a service consumer. In oneembodiment, the providers of the services can comprise healthcareproviders such as hospital, doctors, physical therapists, counsellors,out-patient and/or urgent care facilities, pharmacies, or other suchproviders while the consumer can comprise a patient. In suchembodiments, the responsible party systems 320A-320C can comprise, forexample, those servers or other computer systems typically associatedwith an entity responsible for some duties related to the delivery ofand/or payment for those services. For example, responsible parties caninclude third-party payors including but not limited to insurancecompanies, Medicare, Medicaid, and/or other private, governmental, ormixed public/private entities. While described here with reference tohealthcare providers and third-party payors such as insurance companies,it should be understood that various embodiments of the presentdisclosure are not limited to such implementations. Rather, embodimentsof the present invention are believed to be equally adaptable to anduseful in environments and systems which process a large volume ofelectronic records according to complex rules and regulations, businessor financial arrangements, etc.

Regardless of the exact implementation of nature of the entitiesinvolved, the records management and processing system 305 can comprisean intermediary between a plurality of service providers systems315A-315C and the plurality of responsible entity systems 320A-320C. Assuch and as will be described in greater detail below, the recordsmanagement and processing system 305 can maintain a set of recordsrelated to services provided to a consumer by each or the serviceproviders and for which at least one of the responsible entities isresponsible in some way, e.g., granting approval, making a payment,providing some additional information, etc. In the normal course ofprocessing such records and such transactions, the records managementand processing system 305 may experience a delay in the handling of somerecords. For example, delays can be caused by data anomalies in recordsprovided to the records management and processing system 305 by theservice provider systems 315A-315C. In other cases, delays can be causedby a problem or potential problem with the handling of records or theperformance of required actions by the responsible entity systems320A-320C. In the example of the healthcare implementation describedabove, the records can represent, at least in part, payments to be madeby the responsible entities to the service providers and thus, canrepresent accounts receivable for the service providers. As such, thetimely completion of handling such records can directly impacts thecashflow of the service providers. Additionally, the longer processingof such records is delayed, the more likely the payments will becomecontested or otherwise become problematic. In other implementations, thetimely processing of records by the records management and processingsystem 305 can be equally important for a variety of other reasons.

Accordingly, embodiments of the present disclosure are directed tomethods and systems for the timely processing of records by the recordsmanagement and processing system 305 exchanged between the serviceprovider systems 315A-315C and the responsible entity systems 320A-320C.More specifically, the records management and processing system 305 canmaintain a set of rules defining conditions for processing records andassociated actions to affect that processing upon satisfaction of orfailure to satisfy the conditions of that rule. The records managementand processing system 305 can also maintain tags identifying data in arecord, current status of processing of a record, or other informationabout the record. The records management and processing system 305 canapply the rules to the records and assign tags to the records based onthe conditions defined in the applied rules. The records management andprocessing system 305 can then process the records according toworkflows for processing the records based on the assigned tags andapplied rules.

Since the records maintained and processed by the records management andprocessing system 305 relate to transactions or processes that involveactions by one or more of the responsible entity systems 320A-320C, therequirements for processing those records can change based on the needsand/or processes of those systems 320A-320C. For example, in thehealthcare implementation described above, processing may be updated torequire a claim to be submitted to a responsible entity system 320A-320Cin a certain format or with certain supporting documentation. Thesechanges can be relevant to the further processing of records by therecords management and processing system 305. For example, a change by aresponsible entity system 320A affecting the processing of a recordshould be distributed to and implemented by elements of the recordsmanagement and processing system in a timely manner to avoid problemswith the processing of the affected records, e.g., denial of a claim forbeing submitted without a required document etc.

Therefore, and to further facilitate the timely and efficient processingor records, a data update service 325 may be utilized to obtain fromeach of the responsible entity systems 320A-320C update informationrelated to the records being maintained and processed by the recordsmanagement and processing system. More specifically, the data updateservice 325 can periodically, e.g., daily, weekly, monthly, etc.,“crawl” or “scrape” or otherwise access each of the responsible entitysystems 320A-320C and collect therefrom information related to recordsprocessing updates. For example, the data update service 325 can accesseach responsible entity system through a portal or other means usingpreviously issued credentials or other authentication and authorizationmechanisms in a manner as can be understood by one skilled in the art.The data update service 325 can comprise, for example, a third-partyservice, i.e., separate from the other systems 305, 315A-315C and/or320A-320C and operated by a different entity, and to which the recordsmanagement and processing system 305 may subscribe or otherwise obtainpermission to access and engage. In other cases, the data update service325 may be integrated into the records management and processing system305 or even one or more of the responsible entity systems 320A-320C orservice provider systems 315A-315C.

Regardless of exactly how or where it is implemented, the recordsmanagement and processing system 305 can receive update information fromthe data update service 325 related to the records being processed. Theupdate information provided by the data update service 325 can comprise,for example, a set of information describing and/or defining proceduresto processing records, formats required for records, additionalinformation to be provided and/or processes to be performed in theprocessing of records, etc. The set of update information received bythe records management and processing system 305 from a data updateservice 325 can be parsed into sets of discrete update instructionsrelated to processing of the records. The records management andprocessing system 305 can then assign each of the sets of updateinstructions to certain categories of resources. For example, theresources may comprise human agents, automated agents and/or processes,or combinations thereof for processing the records. The recordsmanagement and processing system 305 can then forward the updateinstructions to the resources for implementation in processing therecords. Additional details of the records management and processingsystem 305 and the processes performed therein will be described below.

FIG. 4 is a block diagram illustrating elements of an exemplary recordsmanagement and processing system according to one embodiment of thepresent disclosure. As illustrated in this example, the recordsmanagement and processing system 305 as described above can comprise aset of records maintained in a database 405 or other repository. Asnoted above, each record of the set of records in the database cancomprise a record of a service provided to a consumer by a serviceprovider and can identify at least one required action by at least oneresponsible entity of a plurality of responsible entities. Also, asdescribed above, the records management and processing system 305 cancomprise an intermediary between systems of the plurality of serviceproviders and systems of the plurality of responsible entities.

The records management and processing system 305 can also maintain oneor more rules 410 for managing and processing the records of thedatabase 405. Generally speaking, a rule can comprise a definition ofone or more conditions and an associated one or more actions to beperformed upon satisfaction, or failure to satisfy, the conditions ofthat rule. Accordingly, each rule 410 maintained by the recordsmanagement and processing system 305 can comprise one or more conditionsfor processing one or more records of the set of records 405 and atleast one associated action to affect processing of the one or morerecords upon satisfaction of or failure to satisfy the one or moreconditions of the rule 410. The conditions defined in some of theserules 410 can comprise conditions to be satisfied by one or more of theresponsible entities 320A-320C described above. For example, one or morerules can define timing or other conditions a payment by a third-partypayor, e.g., Medicare, Medicaid, an insurance company, etc., for aservice rendered by the service provider, e.g., a hospital, doctor,pharmacy, etc., to the consumer/patient. Additionally, or alternatively,conditions defined in some of the rules 410 can define parameters fordata in the record. For example, rules 410 can be defined for performingchecks on the values of various fields of data in the records 405 suchas comparing different fields, e.g., a value of total charges relativeto a value of total adjustments, etc.

To facilitate definition of the rules 410, the records management andprocessing system 305 can further comprise a rules definition module415. Generally speaking, the rules definition module 415 can compriseone or more applications executed by the records management andprocessing system 305 and which provide a rules definition interface420. The rules definition interface 420 can include, for example, one ormore webpages or other, similar interfaces providing elements throughwhich an authorized user, such as an administrator or manager, canselect or otherwise input conditions and corresponding actions for a newor modified rule. Once defined in this manner, the new or modified rulecan be saved in the set of rules 410 and made available for applicationby the records management and processing system 305.

The records management and processing system 305 can also maintain a setof tags 425 for managing and processing the records 405. Generallyspeaking, these tags 425 can comprise a flag, metadata, or otherinformation used to describe, explain, mark, or otherwise identifyrecords in the set of records 405. For example, the tags 425 caninclude, but are not limited to, tags used to identify data in a record405, a current status of processing of the record 405, or otherinformation about the record. As will be described, these tags 425 canbe used to identify records 405 that merit additional attention and/orprocessing and thus, the absence of tags associated with a record canimplicitly indicate that additional attention or handling is not neededfor that record.

To facilitate definition and use of the tags 425, the records managementand processing system 305 can further comprise a tag definition andassignment module 430. Generally speaking, the tag definition andassignment module 430 can comprise one or more applications executed bythe records management and processing system 305 and which provide a tagdefinition and assignment interface 435. The tag definition andassignment interface 435 can include, for example, one or more webpagesor other, similar interfaces providing elements through which anauthorized user, such as an administrator or manager, can select orotherwise input definitions of new or modified tags. Once defined inthis manner, the new or modified tag can be saved in the set of tags 430and made available for application by the records management andprocessing system 305.

The records management and processing system 305 can also comprise arules engine 440. Generally speaking, the rules engine can comprise oneor more applications executed by the records management and processingsystem 305 and which can read and apply the rules 410 to the records405. That is, the rules engine 440 can compare the records stored in thedatabase 405 to the conditions for the rules 410 and, upon findingrecords that satisfy, or fail to satisfy as the case may be anddepending upon how the condition is defined, can perform or cause to beperformed the action associated with the satisfied or failed condition.These actions can include, for example, applying one or more of the tags425 to the identified records 405 or presenting the identified recordsto a user and receiving an indication of the tag(s) to be applied. Thetag(s) 425 applied to a record can identify or mark that record forfurther attention to advance the processing of that record. Thus,records that are not tagged do not require additional attention orprocessing outside of normal processes since they are in a condition asdefined in the rules as being normal or acceptable, e.g., within defineddeadlines or other time limits etc. In other words, processing can beapplied to one set of records based on the tags applied while processingof another set of records can be postponed or delayed so that the firstset of records can be given more attention and resources.

The rules engine 440 can apply the rules 410 to the records 405periodically, on demand, or upon the occurrence of predefined event orthe satisfaction of one or more predefined conditions. For example, therules engine 440 can apply the rules 410 as part of a routine processperformed each day, week, month, or other period, and/or may beinitiated or kicked off upon request by an authorized user of the systemsuch as a manager or supervisor. As noted above, applying the rules 410can include tagging one or more records based on the applied rules 410.Additionally, or alternatively, tags can be applied to one or morerecords based on a user selection or input. For example, a user viewinga set of records can select records from that set and apply one or moretags to those selected records based on conditions the user perceivesand which may or may not be defined in the rules. Thus, tagging ofrecords can be driven by the applied rules or based on input from a userand the tags applied in either way can influence the further handling ofthose tagged records.

According to one embodiment and as illustrated here, the recordsmanagement and processing system 305 can also comprise a workflow engine445 and a set of predefined workflows 450. Generally speaking, aworkflow 450 can comprise a set of one or more steps to be performed onor related to a record. These steps can be wholly machine executable ormay, in some cases, rely on some degree of human intervention. Forexample, these steps can range from presenting data from a tagged recordin a user interface to a human operator, such as a collector, for anaction to be performed by the operator, e.g., calling a payor orperforming some other follow-up action, to a completely automatedprocess such as sending an automatically generated communication to apayor system or combinations of various such human and machine actions.The workflow engine 445 can comprise one or more applications executedby the records management and processing system 305 and which, duringexecution, can read the predefined workflows 450 and implement orperform the steps defined therein. The workflows 450 can comprise a setof predefined, executable steps directed to advancing the processing ofthe records 405 identified by the rules 405 and tagged as describedabove. The workflow engine 445 can execute the workflows 450 byselecting a workflow 450 based on the tags 425 for a record 405 andexecuting the selected workflow 450 using the information from thatrecord and, in some cases, based on further application of one or morerules 410 related to the tags 425 applied to that record 405. Thus, theconditions and associated actions defined in the rules 410 can also beapplied by the workflow engine 445 as it executes the workflows 450. Theworkflow engine 445 can also provide a workflow user interface 450 forviewing and managing one or more workflows for processing records.

Therefore, the rules engine 440 can apply one or more of the rules 410to the records saved in the database 405 to identify those records whichshould be further processed or given further scrutiny and mark thoserecords with one or more tags 425. In this way, those records found tobe within normal or acceptable conditions according to the applied rulesneed not be subjected to further scrutiny and/or processing thus savingresources such as human effort, processing overhead, etc. In otherwords, processing of one set of records can be performed in an expeditedor priority manner while processing of another set of records can bede-prioritized or postponed based on the tags applied to the recordswhich is in turn based on the rules or input from a user.

One or more predefined workflow processes 450 can then be selected,e.g., based on the applied tags, initiated, and executed by the workflowengine 445 to further process those tagged records. The workflows 450can be initiated automatically, e.g., triggered by the rules engine 445upon completion of applying the tags 425, upon the occurrence of certainconditions, e.g., as defined in one or more rules 410, at apredetermined or pre-scheduled time, upon request, or in a variety ofother ways without departing from the scope of the present disclosure.Processing the tagged records 405 by the workflow engine 445 cancomprise performing the steps defined in the workflows 450, which caninclude applying the selected or additional rules 410 to the recordsbeing processed, in order to advance the handling of those records 405by the records management and processing system 305, e.g., move anaccount towards payment or other resolution. Additional details ofprocessing the records 405 by the workflow engine 445 based on theapplied rules 410 and tags 425 according to various embodiments of thepresent disclosure will be described below.

As noted above, to further facilitate this processing of records, a dataupdate service 325 may be utilized to obtain from each of theresponsible entity systems 320A-320C update information 465 related tothe processing of the records 405 being maintained and processed by therecords management and processing system 305. Accordingly, the recordsmanagement and processing system 305 can further include a datacollection and update module 460 for interfacing with the data updateservice 325, receiving update information 465 therefrom, and distributethe update information for implementation in the workflows 450processing the records 405.

More specifically, a set of update information 465 related to one ormore of the records 405 can be received by the data collection andupdate module 460 of the records management and processing system 305from a data update service 325. Generally speaking, the updateinformation 465 can comprise a set of information describing and/ordefining procedures to processing records, formats required for records,additional information to be provided and/or processes to be performedin the processing of records, etc.

The set of update information 465 received by the records management andprocessing system 305 from a data update service 325 can be parsed bythe update module 460 into sets of instructions related to processing ofthe records 405. This parsing can be based on keywords and/or semanticsearches on the contents of the update information 465. For example, theupdate module 460 can parse the update information 465 by identifying,e.g., based on keywords, portions of the update information documentrelated to particular types of records, records having a specific statusor record type, records related to a specific responsible party, and/orother information or combinations thereof. Once these portions of theupdate information 465 have been identified, they can be used by theupdate module 460 to generate or provide specific instructions forprocessing such records.

The update module 460 can then assign each of the one or more sets ofinstructions can to one or more categories of a plurality of pre-definedcategories of resources. Each of the plurality of pre-defined categoriesof resources can comprise one or more resources of the recordsmanagement and processing system 305 performing processing on theplurality of records 405 according to the one or more workflows 450. Forexample, the resources may comprise human agents, automated agentsand/or processes, or combinations thereof for implementing the workflows450 and processing the records 405. The update module 460 can assign theparsed sets of instructions by identifying, e.g., based on the same ordifferent keywords, those resources to which an update instruction canbe relevant. Additionally, or alternatively, these associations can bedefined in one or more rules 410 applied to the records 405 and/or theupdate information or in the workflows themselves 450.

The update module 460 can then forward the one or more sets ofinstructions to each of the resources in the one or more categories towhich the sets of instructions have been assigned. That is, the updateinformation parsed into more narrowly defined sets of instructions canbe distributed to all resources of the records management and processingsystem 305 to which that update may be relevant as defined by thepre-defined categories to which the update instructions are assigned andwith which the resources are associated.

According to one embodiment, the update module 460 can also monitorprocessing of the plurality of records 405 according to the one or moreworkflows 450 and the distributed one or more sets of updateinstructions. For example, the workflows 450 and/or resources can bemonitored by the update module 460 to determine whether the updateinstructions are being executed or followed and the records 405 arebeing processed according to the update instructions, whether processingof the records 405 is being completed successfully, whether errors ordelays in processing of the records 405 are occurring, e.g., because offailure to apply or follow the update instructions, etc. Such conditionscan be detected based on the results of processing the records 405, byconditions defined, for example in the applied rules 410 and detectedduring processing, by algorithms and/or heuristics defined in theworkflows 450 and/or elsewhere, etc.

The update module 460 can also track results of processing the records405 according to the workflows 450 and the distributed sets of updateinstructions. That is, based on monitoring the processing of therecords, the update module 460 can generate a history of the resultsindicating whether the distributed update instructions were applied inthe processing of the records 405. Additionally, or alternatively,tracking the processing the plurality of records according to theworkflows 450 and the distributed update instructions can comprisegenerating metrics such as a compliance rate, failure rate, and/or othermetrics indicating the success or failure of applying the updates. Suchtracking can be performed by the update module 460, for example, onindividual updates, for updates from particular parties, on individualresources, for groups of resources in certain pre-defined categories ofresource, for all resources in each category, etc.

In some cases, the update module 460 can also analyze results ofprocessing records 405 according to the workflows 450 and thedistributed update instructions based on the tracking of the resultsthereof. For example, the update module 460 can analyze the results byidentifying certain types of updates and/or parties providing thoseupdates that are have an implementation success rate below a certainthreshold. This may be indicative of inaccurate or improper parsingand/or distribution of those updates. In another example, the updatemodule 460 can analyze the results by identifying certain resources orpre-defined categories of resources having lower an implementationsuccess rate below a certain threshold. This may be indicative ofperformance issues with a given resource or group of resources, mayindicate a need to adjust the resources assigned to one or morecategories, and/or may indicate a need to adjust the definition of thecategories themselves.

According to one embodiment, the update module 460 can also implementone or more actions based on the analyzing the results of processing therecords 405 according to the workflows 450 and distributed updateinstructions. For example, the update module 460 may implement orinitiate changes to the workflows 450 or the rules 410 applied to therecords 405 based on analyzing the results of processing the records 405according to the workflows 450 and the distributed update instructions.In another example, the update module 460 may implement changes to thepre-defined categories of resources or resources assigned to orassociated with the pre-defined categories based on analyzing theresults of processing the plurality of records 405 according to theworkflows 450 and the distributed update instructions. In yet anotherexample, the update module 460 may predict one or more action to performin addition to the workflows 450 and rules 410 to implement the updates.

FIG. 5 is a flowchart illustrating an exemplary process for implementingupdates directed to the processing of database records according to oneembodiment of the present disclosure. As illustrated in this example,implementing updates directed to the processing of database records cancomprise maintaining and processing 505 a plurality of records in adatabase as described above. As noted, each record of the plurality ofrecords can comprise a record of a service provided to a consumer by aservice provider of a plurality of service providers and can identify atleast one required action by at least one responsible entity of aplurality of responsible entities. The plurality of records can beprocessed according to one or more workflows based on one or more rulesapplied to the plurality of records.

A set of update information directed to the processing of the pluralityof records can be received 510 from a data update service. The updateinformation can be collected by a data update service from the systemsof the plurality of responsible entities. Generally speaking, the updateinformation can comprise a set of information describing and/or definingprocedures to processing records, formats required for records,additional information to be provided and/or processes to be performedin the processing of records, etc.

The received 510 set of update information can be parsed 515 into one ormore sets of instructions related to processing of one or more recordsof the plurality of records. Parsing 515 the update information can bebased on keywords and/or semantic searches on the contents of the updateinformation. For example, parsing 515 can comprise identifying, e.g.,based on keywords, portions of the update information document relatedto particular types of records, records having a specific status orrecord type, records related to a specific responsible party, and/orother information or combinations thereof. Once these portions of theupdate information have been identified, they can be used to generate orprovide specific instructions for processing such records.

Each of the one or more sets of instructions can then be assigned 520 toone or more categories of a plurality of pre-defined categories ofresources. Each of the plurality of pre-defined categories of resourcescan comprise one or more resources of the records management andprocessing system performing processing on the plurality of recordsaccording to the one or more workflows. For example, the resources maycomprise human agents, automated agents and/or processes, orcombinations thereof for implementing the workflows and processing therecords. Assigning 520 the parsed 515 sets of instructions can compriseidentifying, e.g., based on the same or different keywords, thoseresources to which an update instruction can be relevant. Additionally,or alternatively, these associations can be defined in one or more rulesapplied to the records and/or the update information or in the workflowsthemselves.

The one or more sets of instructions can then be forwarded 525 to eachof the one or more resources in the one or more categories to which thesets of instructions have been assigned. That is, the update informationparsed 515 into more narrowly defined sets of instructions can bedistributed to all resources of the records management and processingsystem to which that update may be relevant as defined by thepre-defined categories to which the update instructions are assigned 520and with which the resources are associated.

Processing of the plurality of records according to the one or moreworkflows and the one or more sets of instructions can be monitored 530.For example, the workflows and/or resources can be monitored todetermine whether the update instructions are being executed or followedand the records are being processed according to the updateinstructions, whether processing of the records is being completedsuccessfully, whether errors or delays in processing of the records areoccurring, e.g., because of failure to apply or follow the updateinstructions, etc. Such conditions can be detected based on the resultsof processing the records, by conditions defined, for example in theapplied rules and detected during processing, by algorithms and/orheuristics defined in the workflows and/or elsewhere, etc.

Results of processing the plurality of records according to the one ormore workflows and the one or more sets of instructions can be tracked535. That is, based on monitoring 530 the processing of the records, ahistory of the results indicating whether the one or more sets ofinstructions were applied in the processing of the plurality of recordscan be generated. Additionally, or alternatively, tracking 535 theprocessing the plurality of records according to the one or moreworkflows and the one or more sets of instructions can comprisegenerating metrics such as a compliance rate, failure rate, and/or othermetrics indicating the success or failure of applying the updates. Suchtracking 535 can be performed, for example, on individual updates, forupdates from particular parties, on individual resources, for groups ofresources in certain pre-defined categories of resource, for allresources in each category, etc.

The results of processing the plurality of records according to the oneor more workflows and the one or more sets of instructions can beanalyzed 540 based on tracking 535 the results thereof. For example, theanalysis 540 can comprise identifying certain types of updates and/orparties providing those updates that are have an implementation successrate below a certain threshold. This may be indicative of inaccurate orimproper parsing and/or distribution of those updates. In anotherexample, the analysis 540 can comprise identifying certain resources orpre-defined categories of resources having lower an implementationsuccess rate below a certain threshold. This may be indicative ofperformance issues with a given resource or group of resources, mayindicate a need to adjust the resources assigned to one or morecategories, and/or may indicate a need to adjust the definition of thecategories themselves.

One or more actions can then be implemented 545 based on the analyzing540 of the results of processing the plurality of records according tothe workflows and set of update instructions. For example, implementing545 one or more actions can comprise implementing changes to the one ormore workflows or the rules applied to the plurality of records based onanalyzing the results of processing the plurality of records accordingto the one or more workflows and the one or more sets of instructions.In another example, implementing 545 one or more actions can compriseimplementing changes to the plurality of pre-defined categories ofresources or one or more resources of at least one of the pre-definedcategories of resources based on analyzing the results of processing theplurality of records according to the one or more workflows and the oneor more sets of instructions. In yet another example, implementing 545one or more actions can comprise predicting one or more action toperform in addition to the one or more workflows and rules to implementthe updates. Other possible actions are contemplated and considered tobe within the scope of the present disclosure.

The present disclosure, in various aspects, embodiments, and/orconfigurations, includes components, methods, processes, systems, and/orapparatus substantially as depicted and described herein, includingvarious aspects, embodiments, configurations embodiments,sub-combinations, and/or subsets thereof. Those of skill in the art willunderstand how to make and use the disclosed aspects, embodiments,and/or configurations after understanding the present disclosure. Thepresent disclosure, in various aspects, embodiments, and/orconfigurations, includes providing devices and processes in the absenceof items not depicted and/or described herein or in various aspects,embodiments, and/or configurations hereof, including in the absence ofsuch items as may have been used in previous devices or processes, e.g.,for improving performance, achieving ease and\or reducing cost ofimplementation.

The foregoing discussion has been presented for purposes of illustrationand description. The foregoing is not intended to limit the disclosureto the form or forms disclosed herein. In the foregoing DetailedDescription for example, various features of the disclosure are groupedtogether in one or more aspects, embodiments, and/or configurations forthe purpose of streamlining the disclosure. The features of the aspects,embodiments, and/or configurations of the disclosure may be combined inalternate aspects, embodiments, and/or configurations other than thosediscussed above. This method of disclosure is not to be interpreted asreflecting an intention that the claims require more features than areexpressly recited in each claim. Rather, as the following claimsreflect, inventive aspects lie in less than all features of a singleforegoing disclosed aspect, embodiment, and/or configuration. Thus, thefollowing claims are hereby incorporated into this Detailed Description,with each claim standing on its own as a separate preferred embodimentof the disclosure.

Moreover, though the description has included description of one or moreaspects, embodiments, and/or configurations and certain variations andmodifications, other variations, combinations, and modifications arewithin the scope of the disclosure, e.g., as may be within the skill andknowledge of those in the art, after understanding the presentdisclosure. It is intended to obtain rights which include alternativeaspects, embodiments, and/or configurations to the extent permitted,including alternate, interchangeable and/or equivalent structures,functions, ranges or steps to those claimed, whether or not suchalternate, interchangeable and/or equivalent structures, functions,ranges or steps are disclosed herein, and without intending to publiclydedicate any patentable subject matter.

What is claimed is:
 1. A method for implementing updates directed to theprocessing of database records, the method comprising: maintaining, by arecords management and processing system, a plurality of records in adatabase, each record of the plurality of records comprising a record ofa service provided to a consumer by a service provider of a plurality ofservice providers and identifying at least one required action by atleast one responsible entity of a plurality of responsible entities andwherein the records management and processing system comprises anintermediary between systems of the plurality of service providers andsystems of the plurality of responsible entities; processing, by therecords management and processing system, the plurality of recordsaccording to one or more workflows executed by the records managementand processing system, wherein the one or more workflows process theplurality of records based on one or more rules applied to the pluralityof records; receiving, by the records management and processing systemfrom a data update service, a set of update information directed to theprocessing of the plurality of records, wherein the update informationis collected by the data update service from the systems of theplurality of responsible entities and defines requirements of one ormore of the responsible entities to be satisfied by the plurality ofservice providers or systems of the plurality of service providers, therequirements comprising one or more of procedures to be followed whenprocessing one or more records of the plurality of records, formattingrequired for one or more records of the plurality of records, additionalinformation required for one or more records of the plurality ofrecords, or processes to be performed when processing one or morerecords of the plurality of records; parsing, by the records managementand processing system, the received set of update information into oneor more sets of instructions related to processing of one or morerecords of the plurality of records; assigning, by the recordsmanagement and processing system, each of the one or more sets ofinstructions to one or more categories of a plurality of pre-definedcategories of resources, each of the plurality of pre-defined categoriesof resources comprising one or more resources of the records managementand processing system performing processing on the plurality ofworkflows according to the one or more workflows; and forwarding, by therecords management and processing system, the one or more sets ofinstructions to each of the one or more resources in the one or morecategories to which the sets of instructions have been assigned.
 2. Themethod of claim 1, further comprising monitoring, by the recordsmanagement and processing system, processing of the plurality of recordsaccording to the one or more workflows and the one or more sets ofinstructions.
 3. The method of claim 2, further comprising tracking, bythe records management and processing system, results of processing theplurality of records according to the one or more workflows and the oneor more sets of instructions, the results indicating whether the one ormore sets of instructions were applied in the processing of theplurality of records.
 4. The method of claim 3, further comprisinganalyzing, by the records management and processing system, the resultsof processing the plurality of records according to the one or moreworkflows and the one or more sets of instructions.
 5. The method ofclaim 4, further comprising, implementing, by the records management andprocessing system, changes to the one or more workflows or the rulesapplied to the plurality of records based on analyzing the results ofprocessing the plurality of records according to the one or moreworkflows and the one or more sets of instructions.
 6. The method ofclaim 4, further comprising, implementing, by the records management andprocessing system, changes to the plurality of pre-defined categories ofresources or one or more resources of at least one of the pre-definedcategories of resources based on analyzing the results of processing theplurality of records according to the one or more workflows and the oneor more sets of instructions.
 7. The method of claim 4, furthercomprising, predicting, by the records management and processing system,one or more action to perform in addition to the one or more workflowsand rules to implement the updates.
 8. A system comprising: a processor;and a memory coupled with and readable by the processor and storingtherein a set of instructions which, when executed by the processor,causes the processor to implement updates directed to the processing ofdatabase records by: maintaining a plurality of records in a database,each record of the plurality of records comprising a record of a serviceprovided to a consumer by a service provider of a plurality of serviceproviders and identifying at least one required action by at least oneresponsible entity of a plurality of responsible entities and whereinthe records management and processing system comprises an intermediarybetween systems of the plurality of service providers and systems of theplurality of responsible entities; processing the plurality of recordsaccording to one or more workflows executed by the records managementand processing system, wherein the one or more workflows process theplurality of records based on one or more rules applied to the pluralityof records; receiving, from a data update service, a set of updateinformation directed to the processing of the plurality of records,wherein the update information is collected by the data update servicefrom the systems of the plurality of responsible entities and definingrequirements of one or more of the responsible entities to be satisfiedby the plurality of service providers or systems of the plurality ofservice providers, the requirements comprising one or more of proceduresto be followed when processing one or more records of the plurality ofrecords, formatting required for one or more records of the plurality ofrecords, additional information required for one or more records of theplurality of records, or processes to be performed when processing oneor more records of the plurality of records; parsing the received set ofupdate information into one or more sets of instructions related toprocessing of one or more records of the plurality of records; assigningeach of the one or more sets of instructions to one or more categoriesof a plurality of pre-defined categories of resources, each of theplurality of pre-defined categories of resources comprising one or moreresources of the records management and processing system performingprocessing on the plurality of workflows according to the one or moreworkflows; and forwarding the one or more sets of instructions to eachof the one or more resources in the one or more categories to which thesets of instructions have been assigned.
 9. The system of claim 8,wherein the instructions further cause the processor to monitoring, bythe records management and processing system, processing of theplurality of records according to the one or more workflows and the oneor more sets of instructions.
 10. The system of claim 9, wherein theinstructions further cause the processor to track results of processingthe plurality of records according to the one or more workflows and theone or more sets of instructions, the results indicating whether the oneor more sets of instructions were applied in the processing of theplurality of records.
 11. The system of claim 10, wherein theinstructions further cause the processor to analyze the results ofprocessing the plurality of records according to the one or moreworkflows and the one or more sets of instructions.
 12. The system ofclaim 11, wherein the instructions further cause the processor toimplement changes to the one or more workflows or the rules applied tothe plurality of records based on analyzing the results of processingthe plurality of records according to the one or more workflows and theone or more sets of instructions.
 13. The system of claim 11, whereinthe instructions further cause the processor to implement changes to theplurality of pre-defined categories of resources or one or moreresources of at least one of the pre-defined categories of resourcesbased on analyzing the results of processing the plurality of recordsaccording to the one or more workflows and the one or more sets ofinstructions.
 14. The system of claim 11, wherein the instructionsfurther cause the processor to predict one or more action to perform inaddition to the one or more workflows and rules to implement theupdates.
 15. A non-transitory, computer-readable medium comprising a setof instructions stored therein which, when executed by a processor,causes the processor to implementing updates directed to the processingof database records by: maintaining, by a records management andprocessing system, a plurality of records in a database, each record ofthe plurality of records comprising a record of a service provided to aconsumer by a service provider of a plurality of service providers andidentifying at least one required action by at least one responsibleentity of a plurality of responsible entities and wherein the recordsmanagement and processing system comprises an intermediary betweensystems of the plurality of service providers and systems of theplurality of responsible entities; processing, by the records managementand processing system, the plurality of records according to one or moreworkflows executed by the records management and processing system,wherein the one or more workflows process the plurality of records basedon one or more rules applied to the plurality of records; receiving, bythe records management and processing system from a data update service,a set of update information directed to the processing of the pluralityof records, wherein the update information is collected by the dataupdate service from the systems of the plurality of responsible entitiesand defining requirements of one or more of the responsible entities tobe satisfied by the plurality of service providers or systems of theplurality of service providers, the requirements comprising one or moreof procedures to be followed when processing one or more records of theplurality of records, formatting required for one or more records of theplurality of records, additional information required for one or morerecords of the plurality of records, or processes to be performed whenprocessing one or more records of the plurality of records; parsing, bythe records management and processing system, the received set of updateinformation into one or more sets of instructions related to processingof one or more records of the plurality of records; assigning, by therecords management and processing system, each of the one or more setsof instructions to one or more categories of a plurality of pre-definedcategories of resources, each of the plurality of pre-defined categoriesof resources comprising one or more resources of the records managementand processing system performing processing on the plurality ofworkflows according to the one or more workflows; and forwarding, by therecords management and processing system, the one or more sets ofinstructions to each of the one or more resources in the one or morecategories to which the sets of instructions have been assigned.
 16. Thenon-transitory, computer-readable medium of claim 15, wherein theinstructions further cause the processor to monitoring, by the recordsmanagement and processing system, processing of the plurality of recordsaccording to the one or more workflows and the one or more sets ofinstructions.
 17. The non-transitory, computer-readable medium of claim16, wherein the instructions further cause the processor to trackresults of processing the plurality of records according to the one ormore workflows and the one or more sets of instructions, the resultsindicating whether the one or more sets of instructions were applied inthe processing of the plurality of records.
 18. The non-transitory,computer-readable medium of claim 17, wherein the instructions furthercause the processor to analyze the results of processing the pluralityof records according to the one or more workflows and the one or moresets of instructions.
 19. The non-transitory, computer-readable mediumof claim 18, wherein the instructions further cause the processor toimplement changes to the one or more workflows, the rules applied to theplurality of records, the plurality of pre-defined categories ofresources, or one or more resources of at least one of the pre-definedcategories of resources based on analyzing the results of processing theplurality of records according to the one or more workflows and the oneor more sets of instructions.
 20. The non-transitory, computer-readablemedium of claim 18, wherein the instructions further cause the processorto predict one or more action to perform in addition to the one or moreworkflows and rules to implement the updates.